Intradiscal Pressure Recordings in the Cervical Spine

Pospiech, J.; Stolke, D.; Wilke, Hans–Joachim; Claes, Lutz

doi:10.1097/00006123-199902000-00078

Cited by 173 publications

(109 citation statements)

References 32 publications

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“…Consistent with other results reported in the literature, 3,4,6,10,50 the current study noted higher biomechanical changes above the fused segments. A few biomechanical investigations have also shown greater disc stress (or pressure) and motion changes at the inferior levels than at the superior levels in 1-and 2-level cervical fusions, 26,39 whereas no significant 22,41,43 or even decreased 45 biomechanical changes have been recorded at the adjacent segments after 1-level cervical arthrodesis.…”

Section: Discussionmentioning

confidence: 99%

Relationship between biomechanical changes at adjacent segments and number of fused bone grafts in multilevel cervical fusions: a finite element investigation

Hussain

Nassr

Natarajan

et al. 2014

SPI

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Object Biomechanical studies have shown that anterior cervical fusion construct stiffness and arthrodesis rates vary with different reconstruction techniques; however, the behavior of the adjacent segments in the setting of different procedures is poorly understood. This study was designed to investigate the adjacent-segment biomechanics after 3 different anterior cervical decompression and fusion techniques, including 3-level discectomy and fusion, 2-level corpectomy and fusion, and a corpectomy-discectomy hybrid technique. The authors hypothesized that biomechanical changes at the segments immediately superior and inferior to the multilevel fusion would be inversely proportional to the number of fused bone grafts and that these changes would be related to the type of fusion technique. Methods A previously validated 3D finite element model of an intact C3–T1 segment was used. Three C4–7 fusion models were built from this intact model by varying the number of bone grafts used to span the decompression: a 1-graft model (2-level corpectomy), a 2-graft model (C-5 corpectomy and C6–7 discectomy), and a 3-graft model (3-level discectomy). The corpectomy and discectomy models were also previously validated and compared well with the literature findings. Range of motion, disc stresses, and posterior facet loads at the segments superior (C3–4) and inferior (C7–T1) to the fusion construct were assessed. Results Motion, disc stresses, and posterior facet loads generally increased at both of the adjacent segments in relation to the intact model. Greater biomechanical changes were noted in the superior C3–4 segment than in the inferior C7–T1 segment. Increasing the number of bone grafts from 1 to 2 and from 2 to 3 was associated with a lower magnitude of biomechanical changes at the adjacent segments. Conclusions At segments adjacent to the fusion level, biomechanical changes are not limited solely to the discs, but also propagate to the posterior facets. These changes in discs and posterior facets were found to be lower for discectomy than for corpectomy, thereby supporting the current study hypothesis of inverse relationship between the adjacent-segment variations and the number of fused bone grafts. Such changes may go on to influence the likelihood of adjacent-segment degeneration accordingly. Further studies are warranted to identify the causes and true impact of these observed changes.

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Section: Discussionmentioning

confidence: 99%

Relationship between biomechanical changes at adjacent segments and number of fused bone grafts in multilevel cervical fusions: a finite element investigation

Hussain

Nassr

Natarajan

et al. 2014

SPI

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“…The posterior aspect of the disc space has to be coated with gelatin before pouring the methyl methacrylate in a semiliquid consistency into the intervertebral space. Cervical interbody fusion with bone cement is assumed to have a good primary stabilizing effect and is an accepted operative procedure [8,22,25]. Therefore, it will serve as a baseline for comparison with the three cages.…”

Section: Devicesmentioning

confidence: 99%

Primary stabilizing effect of interbody fusion devices for the cervical spine: an in vitro comparison between three different cage types and bone cement

Wilke¹,

Kettler²,

Claes³

2000

European Spine Journal

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“…There is mounting evidence that arthrodesis increases stress and, therefore, the rate of disc degeneration in the cervical spine. 2,4,5,13,21,26,38,41,55 The results of a cervical disc prosthesis, which was originally developed in Bristol, England, have been reported. 10 The second-generation Cummins disc is a ball-andtrough-type device constructed of stainless steel.…”

Section: Cervical Arthroplastymentioning

confidence: 99%

Spinal arthroplasty

Traynelis¹

2002

FOC

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Symptomatic degenerative spinal disease is a serious medical condition that affects many individuals. Modern neuroimaging modalities, the development of new medications, and advances in operative and nonoperative treatments have all contributed to improved outcomes. Unfortunately, there remain a significant number of patients in whom primary therapy either fails or new or recurrent symptoms develop over time. The last decade has witnessed the invention of devices designed to reconstruct the spinal motion segment. These devices can be divided into those that primarily function to replace a nucleus pulposus and those that completely replace the disc complex. In this article the author reviews the background leading to the development of the current group of disc replacements. The design and preliminary clinical results obtained using major lumbar and cervical devices are also reviewed.

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Intradiscal Pressure Recordings in the Cervical Spine

Cited by 173 publications

References 32 publications

Relationship between biomechanical changes at adjacent segments and number of fused bone grafts in multilevel cervical fusions: a finite element investigation

Relationship between biomechanical changes at adjacent segments and number of fused bone grafts in multilevel cervical fusions: a finite element investigation

Primary stabilizing effect of interbody fusion devices for the cervical spine: an in vitro comparison between three different cage types and bone cement

Spinal arthroplasty

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